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Areola: Frequently Asked Questions

What is the areola?

The dark skin (pigmented) area around the nipple. 121

What is the purpose and function of the areola?

The areola helps to support the nipple and also contains Montgomery's glands which help to keep the nipple moisturized during breastfeeding.

How is an areola reduction done?

Basically, a circle is drawn on the areola with the nipple as its center. An incision is made on this line, and all areolar tissue outside the line is removed (deepithelialized) so that the new areolar edge can be sewn to the skin edges. Learn more about areola reduction .

What is Areola Repigmentation?

This procedure is for women who have undergone breast reconstruction surgery and wish to have the areola area repigmented. A physician's consent and several visits may be necessary to complete the procedure.

What causes the colour of the nipple and areola to be darker?

Nipples turn darker in colour due to the production of melanin. This increased production of may be caused by increased female hormones changes especially after adolescence, pregnancy or consumption of oral contraceptives. Sometimes the hyperpigmentation is caused by problems associated with the wearing of bra or sexual habits. This mechanical stimulation may cause an increased inflammation leading to increased pigmentation.

What is done for restoring the nipple and areola?

The final stage of breast restoration takes place after the breast mound is created. Initially the nipple is reconstructed using local tissue, and then medical tattooing is performed to restore the color of the areola. Both of these are performed as minor office procedures.

Why is the color of the nipple/areola complex darker then the rest of the breast?

Most people have more pigment-containing cells in their areolas than the surrounding breast skin, causing a darker coloration.

Is the placement of the nipple and areola affected by a breast lift?

The nipple and areola are left alone and moved by relocating the entire gland.

How is the nipple/areola affected during breast reduction surgery?

The nipple and areola are generally not affected. In most cases, the nipple-areola is left attached and moved by relocating the entire gland. There are rare exceptions, such as with patients who have extremely large breasts.

Does the nipple/areola complex come in an average size or is there an aesthetic ideal?

A wide variety of areolar sizes exist. After reduction surgery, the new areolar diameter is generally set somewhere between 38-48mm, although this can be adjusted based on your goals and the aesthetic opinion of the surgeon. To get an idea of the wide variation in appearance of normal nipples and areolas, visit our nipple gallery .

Is a stretched out nipple/areola complex caused by the weight of the breast or by genetics?

A "stretched out" nipple/areola can be caused by multiple factors including genetics, mechanical forces of the weight of a breast, the elasticity of the skin, age, etc.

Why is there a difference between the sizes of the nipple/areola complex when it's "at rest" versus stimulated?

Smooth muscle fibers in the nipple/areola can contract and thus reduce its size when stimulated.

Does your nipple/areola complex always lose color with breast surgery?

Different people have different responses to surgery. Often, the color remains the same, however, darkening or lightening of the pigment can also occur. Back to Top Feeling

How small can the nipple/areola complex be made and still maintain viability?

There is no real limit of areolar reduction in terms of viability, however, excessive reduction of the areola produces a disproportionate, unaesthetic appearance.

Does the age of the patient have anything to do with the placement of the nipple/areola complex?

The placement of the nipple/areola complex is usually based on the location of the inframammary fold (the fold under the breast). The location of this fold does not change much with age, although the overlying breast tissue can change significantly.

Can sensation of the nipple/areola be lost after breast augmentation surgery?

Yes, a small percentage (<1%) of patients have permanent nipple/areola sensation loss after breast augmentation surgery. Many patients have temporary loss or hyper-sensitivity of the nipple/areola complex. The surgeon takes great care during the operation to avoid injury to the nerve supply to the nipple/areola complex.
Yes, a small percentage (<5%) of patients have permanent nipple/areola sensation loss after breast augmentation surgery. Many patients have temporary loss or hyper-sensitivity of the nipple/areola complex. The surgeon takes great care during the operation to avoid injury to the nerve supply to the nipple/areola complex.
A small percentage (less than 5%) of patients have permanent nipple/areola sensation loss after breast augmentation surgery. Many patients have temporary loss or hyper-sensitivity of the nipple/areola complex. I always take great care during the procedure to ensure that this does not happen.

Will Transfemme change the size of my areola?

Yes, Transfemme will change the size of most biological males areola to look female. We have many men call to tell us their areola have gone from a small dime size to a half dollar or quarter size in a short period of time usually before their breasts get larger. Transfemme will not increase the length of your nipples.

Can I enlarge or reduce the size of my areola?

The areola can be reduced in size or enlarged. This may be done as a standalone type of procedure under local anesthesia. Or, it may be done in conjunction with an augmentation, reduction or lift.

Will my nipple or areola change after implant surgery?

Usually, yes. The nipple may either become more prominent, or flatten somewhat, depending upon your anatomy, the implant size, and implant position. The areolar area almost always enlarges, at least some.

Is there increased risk of nipple/areola complex loss when a revision is needed? If so, why?

The risk is usually low for any minor revisions. If a complete redo of the reduction is performed, the surgeon must know where the blood supply was based during the previous surgery so he or she can preserve the same blood supply "pedicle. " Otherwise, there is a significantly higher risk of nipple/areolar loss.

Why does the nipple/areola complex sometimes not appear to be properly placed on the breast after surgery? Will they return to their proper position?

Some asymmetry may be due to different degrees of swelling in the right versus the left breast. If this is the case, it should improve over time.

Is it normal to have sensation in my nipple but not my areola after breast surgery?

Everyone recovers differently, and different women will experience alternate patterns of sensation during recovery. Usually both nipple and areola sensation will return over time.

Is it possible for the areola to spread or stretch after breast surgery? If so, what is done to fix it?

For any surgical site there is always a risk of widened scarring, and the areola is no exception. In general, periareolar scars tend to blend nicely due to the natural contrast of breast and areolar pigments. When widened scarring or stretching occurs, a revision of the scar can be performed. Sometimes, a permanent "purse-string" stitch can be placed to keep the breast skin around the areola from stretching the diameter of the areola. This is rarely necessary with primary breast reductions or breast lifts.

Why do some women have more sensation in their nipple/areola complex after breast reduction surgery?

Sometimes, the weight of the breast is such that the nerves are stretched by the hanging tissue. In some cases, once a reduction is performed, patients will note improved sensation compared to their preoperative sensation. Also, the generalized inflammation from healing can sometimes cause hypersensitiviy.

Do spitting stitches on the incisions around the nipple/areola complex cause more noticeable scars?

Usually not, unless there is a significant infection with a large wound (rare). If necessary, later scar revision can minimize any postoperative scars.

Why is the color of my nipple/areola complex not different in color from the rest of my breast?

There is a wide variety of areolar colors, and some are distinctly different from the breast skin, while others are more similar or nearly identical in color to the breast skin. These are all normal variations.

When having a liposuction-only breast reduction, does the nipple/areola complex reduce in size itself? If it does not, how is it fixed?

Unlike standard breast reduction, liposuction of the breast does not alter the breasts' overall shape. Rather, it tends to reduce the weight and size of the breast. Likewise, although the areola may decrease in diameter proportionately with the decrease in breast size, it is not reduced or repositioned as it is in standard breast reduction. Only techniques that involve skin removal can dramatically change areolar size.

Can the patient have any input into the size and placement of her nipple/areola complex?

Yes. The sizing and placement of the nipple and areola complex is based on multiple surgical measurements of the breast as well as on established aesthetic ideals. From prior experience, these measurements tend to give the best overall results. These ideals can be adjusted to a certain degree if a patient feels strongly about areolar size or positioning.
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